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Complete mental and physical rest is the accepted primary aim in the treatment of acute myocardial infarction, particularly during the initial stages of the condition. Controversy has arisen during recent years, however, regarding the mode of management for these patients that would be most effective in achieving this goal. Customarily in the past, immediate restriction to bed followed by prolonged periods of strict bed rest has been the therapy of choice, since the concept handed down through the years has been that bed rest if absolutely enforced would afford the most complete rest to the myocardium.1 These ideas have in recent years been contested and are now refuted by some observers.2Many outstanding authorities on the treatment of heart disease are becoming increasingly aware of the several disadvantages and harmful effects observed when patients are kept recumbent or rigidly restricted to bed for long periods during the treatment

The type of treatment and the degree of control of the diabetic state most desirable for optimal management of youthful patients with severe diabetes has long been the subject of much debate. That the duration of diabetes is an important factor in determining the incidence and severity of degenerative vascular lesions among diabetic patients is a well accepted fact. However, our experience has led us to believe that continuous, aggressive treatment directed toward maintaining physiologic conditions, including normal levels of blood sugar, is of the greatest importance in reducing the incidence and severity of degenerative complications.Several recent articles have advocated a regimen of management which by our standards falls far short of being adequate therapy.1 These plans of treatment, in general, allow a more or less free selection of food and disregard of hyperglycemia and glycosuria as long as frank symptoms and acidosis are absent. Many factors must